Consumo de nutrientes e densidade mineral óssea em mulheres pós-menopausadas

Abstract

Menopause is a period marked by several physiological changes that can have negative impacts on women's health, quality of life and healthy aging. Among these changes, bone mass is one of the main tissues affected, given its close relationship with estrogen. Food is a strong ally to minimize or delay bone loss resulting from menopause. Low dietary selenium intake has been associated with a higher prevalence of osteoporosis and lower bone mineral density (BMD). Furthermore, the analysis of the nutrient pattern is an alternative to assess how the consumption of nutrients together is related to bone outcomes. Considering the scarcity of studies that relate nutrient pattern and dietary selenium intake with BMD in postmenopausal Brazilian women, this study aimed to associate dietary selenium intake and nutrient pattern with BMD in postmenopausal women. This was a cross-sectional, analytical, observational study, carried out between June 2019 and March 2020 in a climacteric outpatient clinic of a university hospital, with women in menopause for at least 12 months and aged over 50 years. Sociodemographic, lifestyle, clinical and anthropometric information were collected. The food frequency questionnaire was applied, and the nutrient pattern was identified, through the analysis of principal components, in addition to the dietary intake of selenium. ANOVA, Kruskal-Wallis, Chi-Square, and Fisher's Exact tests were applied for bivariate analyzes and multivariate logistic regression with fitted models were defined to analyze the association between dietary selenium intake and nutrient pattern with BMD. A total of 124 women were included, with a mean age of 66.8 ± 6.1 years and a time since menopause of 19.6 ± 8.8 years. According to the BMD, 41% of the women had osteopenia and 36.6% had osteoporosis. Selenium consumption was associated with BMD, women with higher dietary selenium consumption were less likely to have osteoporosis (OR: 0.02 [95%CI: 0.001-0.4; p = 0.012) when compared to those with lower consumption of this mineral. When assessing the nutrient pattern, women with lower consumption of nutrient pattern 1 and 2 were more likely (OR: 6.64, [95%CI: 1.56-28.16], p = 0.010; OR: 5.03, [95%CI: 1.25-20.32], p = 0.023, respectively) of having osteopenia when compared to women with higher consumption of these patterns. There was no association with osteoporosis. In conclusion, this study demonstrated that higher selenium intake, evaluated alone, was positively associated with osteoporosis, and that nutrient intake, evaluated as a nutrients pattern, was positively associated with osteopenia but not with osteoporosis in postmenopausal women.